Common Birth Defect is Very Treatable

By Karlind Moller, Ph.D.

June 20, 2006

Cleft lip and palate is a condition that can be seen, felt, and heard. A multifaceted condition, it can affect many basic functions and activities--eating, breathing, speaking, and hearing. That's why it is critical to approach the treatment of people with cleft lip and palate early in life and with a multidisciplinary group of professionals.

Cleft lip and palate is the most common birth defect in the United States today, occurring very early in pregnancy and in approximately 1 of 600 births. A cleft lip is a split or separation of the sides of the upper lip; a cleft palate is a separation or opening in the roof of the mouth.

Clefts happen when the skin and muscles of the lip and bones of the palate do not fuse together at the right time, an occurrence that is not completely understood. Cleft lip and palate can occur on one or both sides and can happen together or separately.

The most frequently seen cleft involves the lip, bony gum ridge (where teeth develop), and hard and soft palate¿the roof of mouth. Though parents may be devastated by the appearance of the cleft at birth, it is a condition highly treatable by a wide range of specialists.

Throughout childhood, a child with cleft lip and palate will likely be treated by their primary care physician, surgeon, oral surgeon, ear, nose and throat doctor, audiologist, speech-language pathologist, pediatric or family dentist, orthodontist, prosthodontist (a specialist who can replace missing teeth), and geneticist.

When a baby is born with a cleft lip or palate, treatment should begin right away to provide the best outcome. In the baby¿s first three to 12 weeks of life, a surgeon will repair the lip. When the baby is nine to 12 months old, the surgeon can repair the cleft palate.

As teeth start to come in, they are often out of position, may be underdeveloped, or may be missing in the area of the cleft. At age 5 to 7, the child may have another surgery to graft bone from the hip into the bony gum ridge. Most often, children with cleft lip and palate will need orthodontic braces or will need to have a missing tooth replaced to ensure a satisfactory dental bite and a pleasing appearance and smile.

It is important for families to seek an interdisciplinary team of professionals who will work together to coordinate the best care. Together, they can evaluate the patient's unique needs and formulate the most appropriate plan for treatment throughout the child¿s developing years. Comprehensive interdisciplinary evaluations, along with routine medical and dental treatment, means people with cleft lip and palate lead totally healthy and normal lives.

Karlind Moller, Ph.D., is director of the Cleft Palate and Craniofacial Anomalies Clinics at the University of Minnesota School of Dentistry. He also is a professor in the School of Dentistry, Department of Developmental and Surgical Sciences, and the Department of Speech-Language-Hearing Sciences at the U of M. This column is an educational service of the University of Minnesota. Advice presented should not take the place of an examination by a health-care professional. For more health-related information, go to http://www.healthtalk.umn.edu.